- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $114.55 / $114.55 / $114.55
| Facility | 53 | $114.55 | $114.55 | $114.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,547.24 / $20,448.87 / $39,554.72
| Facility | | $15,547.24 | $20,448.87 | $39,554.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,300.00 / $11,300.00 / $11,300.00
| Facility | | $11,300.00 | $11,300.00 | $11,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.23 / $1,107.47 / $9,696.00
| Facility | | $730.23 | $1,107.47 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $6,350.80 / $6,350.80 / $6,350.80
| Facility | 53 | $6,350.80 | $6,350.80 | $6,350.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,147.51 / $1,399.22 / $1,717.98
| Facility | | $1,147.51 | $1,399.22 | $1,717.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |